The progress of medicine over the years may perhaps somewhat inaccurately but usefully be thought of in terms of its progress from an "art" toward a "science". The development annd systematizing of information used in treating patients with drugs intravenously and through inhalation is particularly interesting. Computer programs which provide regimens of drug treatment based on systematized information and characteristics of a particular patient have in fact provided doctors in a number of instances with the capability to approach more closely the goals of such treatment while avoiding the pitfalls and dangers (e.g. inadequate or toxic levels of the drug in the bloodstream). See, e.g. R. W. Jelliffe, J. Rodman, and E. Kolb, "Clinical Studies with Computer-Assisted Lidocaine (L) Infusion Regimens", Circulation, Vol. 54, No. 4, Suppl. II, p. 211, 1976; R. W. Jelliffe, F. Goicoechea, D. Tuey, M. Wyman, J. Rodman and B. Goldreyer, "An Improved Computer Program for Lidocaine Infusion Regimens", Clinical Research, Vol. 23, p. 125A, February 1975; and R. W. Jelliffe, "A Computer Program for Xylocaine Infusion Regimens", Federation Proceedings, Vol. 32, No. 3, p. 812 Aab, 1973.
Focusing, by way of example, on the drug lidocaine and its use in the treatment of heart attack victims, an historical problem has been achieving sufficient serum levels as early as possible during the first hours of treatment and then reaching and maintaining a target serum level. At the same time, one of course wishes to avoid serum levels which are toxic or which approach toxicity. These goals are of course contradictory in nature, particularly in light of the problem of obtaining a uniform distribution of the drug in the bloodstream and the related delayed reaction of a patient to a change in the infusion rate. As indicated by the above references, computer programs are of significant value in balancing such goals. Further, in response to the requirements which may be called for by such programs, and also as a general matter, a capability to regulate a rate of flow of a drug to a patient in a somewhat automatic, systematic and safe fashion is of great interest to medical practitioners. This is particularly true if a capability to incorporate a large number of frequent changes, or to "fine tune", is included.
The opportunity to free medical personnel for other tasks to the extent that such drug treatment regimens can be mechanized has been somewhat recognized. For example, apparatus has been developed which employs a chart coated with a conductive material and a probe which will follow a curve scratched along the surface of the chart when the chart is placed on a rotating drum to move the curve past the probe. This apparatus may then be used in conjunction with e.g. an anesthesia pump. See catalog and specification material related to Qan, Inc. Dose Regulated Anesthesia Pump (Mark II) and Research, Inc. Model 5500 Data Trak Programmer incorporated in such pump; and H. J. Lowe, Ch. 7--"Automated Programmed Anesthesia", in Dose-Regulated Penthane (Methoxyflurane) Anesthesia, Abbott Laboratories, 1972. The scratched curve creates two isolated planes along the chart which become electrically energized with oppositely phased AC voltages when the chart is placed on the drum. The probe then seeks the zero potential scratched curve, and as it moves along the curve is used to mechanically adjust a potentiometer and thus affect an electrical signal.
A related but quite different approach employs the incorporation of the control of in-house, e.g. in hospitals, devices to control fluid flow rates, such devices themselves under the control of in-house computers. Such in-house systems are particularly adapted to a so-called closed loop operation involving evaluation by the computer of the condition of the patient being treated during such treatment, and adjustment under the control of the computer in light of such condition. Exemplary of this approach is a computer controlled intensive care unit at the University of Alabama Medical Center.